Physician

Rafael Rivera-Rivera, MD

According to 2025 Medicare claims, Rafael Rivera-Rivera, MD (NPI: 1669432209) practices critical care (intensivists) in the Wichita Falls, TX market, with the plurality of this provider's patient population coming from Wichita, TX. This provider's primary affiliated billing organization is PULMONARY SERVICES OF NORTH TEXAS PLLC (NPI: 1275934747; TIN: 471791717) and primary practice location at 76301-5602. Rivera-Rivera is affiliated with the Caravan Health ACO 43 LLC (ACO ID: A4974) and CoreHealth Alliance LLC (ACO ID: A5645), participating under the MSSP model.

Rivera-Rivera's data goes back to 2015 and runs through 2024. For example, in 2024, this provider had 685 traditional Medicare patients, billed 5,926 HCPCS/CPT codes, and received $352,857 in Medicare payments. The top billing code was 99291 (Critical care, first 30-74 minutes). Part D data shows 913 prescription claims across 154 beneficiaries totaling $827,644 in drug costs, led by Ofev (Nintedanib Esylate). DME data shows 1,412 claims. Open Payments data shows 142 records totaling $3,061. You can download detailed data with all billing codes (2015-2024). For more recent data, please contact us.

Over the past 10 years, this provider's Medicare Part B carrier billing has risen steadily, from $269,761 to $352,857. Concurrently, Part D prescription costs have moved up and down with repeated peaks and valleys, starting at $387,316 and ending at $827,644. For DME billing, reported payments rose steadily, from $107,626 to $113,364.

Part B Carrier Billing Trend

Medicare payment trend, with N of patients and claim lines in the table.

Year	Patients	Clm Lines	Payment
2015	970	3,498	$269,761
2016	914	4,569	$277,779
2017	959	5,699	$312,770
2018	810	7,155	$345,036
2019	762	9,472	$392,022
2020	754	7,966	$428,432
2021	625	8,670	$440,647
2022	551	8,551	$393,875
2023	606	8,819	$358,376
2024	685	5,926	$352,857

Part D Events Trend

Drug cost trend, with N of patients and prescription claims in the table.

Year	Patients	Claims	Drug Cost
2015	161	1,053	$387,316
2016	159	1,017	$266,440
2017	157	1,087	$402,565
2018	148	934	$528,962
2019	158	895	$714,555
2020	144	867	$392,203
2021	131	802	$487,357
2022	140	793	$511,964
2023	135	746	$407,844
2024	154	913	$827,644

DME Billing Trend

Medicare payment trend, with N of patients and DME claim records in the table.

Year	Patients	Claims	Payment
2015	344	1,560	$126,302
2016	439	2,001	$125,700
2017	509	2,093	$153,959
2018	361	1,722	$137,369
2019	446	1,926	$189,805
2020	403	1,845	$163,491
2021	347	1,716	$168,965
2022	348	1,620	$191,617
2023	295	1,668	$200,237
2024	246	1,412	$132,532

* / # = suppressed by CMS; 0 = reported zero; N/R = not reported or blank.

Top 5 Part B carrier billing codes in 2024

By total payments.

Code	Description	Patients	Clm Lines	Total Payment
99291	Critical care, first 30-74 minutes	192	417	$160
99214	Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	276	431	$90
99232	Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes	116	166	$59
94729	Test to examine how well the lungs exchange gases	114	114	$34
94726	Test to determine lung volumes using sensors	112	112	$33

Top 5 Part D drugs in 2024

By total drug costs.

Drug	Generic	Claims	Total Day Supply	Total Drug Cost
Ofev	Nintedanib Esylate	17	510	$235,621
Trelegy Ellipta	Fluticasone/Umeclidin/Vilanter	191	7,742	$163,110
Opsumit	Macitentan	13	390	$161,206
Breztri Aerosphere	Budesonide/Glycopyr/Formoterol	71	2,670	$53,960
Spiriva Respimat	Tiotropium Bromide	51	2,010	$34,924

Top 5 DME services in 2024

By Total Medicare Payment Amount.

HCPCS Code	HCPCS Description	Supplier Rental Indicator	Total Supplier Beneficiaries	Total Supplier Claims	Total Medicare Payment Amount
E0466	Home ventilator, any type, used with non-invasive interface, (e.g., mask, chest shell)	Y	N/R	50	$51,054
E1390	Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate	Y	35	317	$24,258
J7677	Revefenacin inhalation solution, fda-approved final product, non-compounded, administered through dme, 1 microgram	N	N/R	23	$19,114
A7031	Face mask interface, replacement for full face mask, each	N	24	55	$4,812
A7030	Full face mask used with positive airway pressure device, each	N	25	55	$4,517

Open Payments Summary in 2024

Category	Definition	Records	Total Reported Amount	Top Related Entity
General Payments	Reported payment or transfer-of-value amount.	142	$3,061	AstraZeneca Pharmaceuticals LP
Research Payments	Reported research-related payment or transfer-of-value amount.	0	$0	N/R
Ownership / Investment Interests	Reported value of ownership or investment interests.	0	$0	N/R

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FAQ

What Medicare data is available for Rafael Rivera-Rivera, MD?

Tedicare shows public-source Medicare data for Rafael Rivera-Rivera, MD (NPI 1669432209), including provider identity, specialty, market context, Medicare Part B activity, Part D prescribing, DME records, Open Payments where available, billing organization details, and ACO affiliation signals where available. Profile data covers 2015-2024, with current attribution based on 2025 claims where available.

Does Rafael Rivera-Rivera, MD have ACO affiliation data?

Rafael Rivera-Rivera, MD is shown with ACO affiliation data for Caravan Health ACO 43 LLC (MSSP, ACO ID A4974) and CoreHealth Alliance LLC (MSSP, ACO ID A5645).

What billing organization is linked to Rafael Rivera-Rivera, MD?

Rafael Rivera-Rivera, MD is linked to PULMONARY SERVICES OF NORTH TEXAS PLLC (billing NPI 1275934747) in the available physician profile data.

Does Rafael Rivera-Rivera, MD have Open Payments data?

Rafael Rivera-Rivera, MD has 142 connected Open Payments records in the available 2024 summary data.

Can I download physician-level Medicare data from Tedicare?

Yes. Tedicare provides sample physician export data and paid custom physician data exports for research, planning, outreach, and market analysis. Exports can include physician profile fields, market and specialty context, billing organization details, ACO affiliation signals where available, and Medicare utilization data.